Could porn addiction become a hypersexual disorder?
Is porn addiction any closer to official recognition in the psychotherapy community? Well, kind of.
The DSM (or Diagnostic and Statistical Manual of Mental Disorders) is the American "bible" of mental health. It is quoted by therapists, researchers, pharmaceutical companies and policy makers from all over the world. The DSM is also used by US health insurance companies to determine which mental disorder treatments they will pay out for.
Right now, porn addiction isn't recognised by the DSM. Neither is sex addiction or internet addiction. In fact, the DSM doesn't like the addiction word at all. But this might all change in the fifth revision, due to be released in 2013. Some proposed changes are:
- A category called “substance-related disorders” would include not only drug and alcohol addiction, but also gambling addiction. Recognition of a "non-substance" addiction like gambling in this category would be a considerable shift.
- Internet addiction might also be covered by this category, though subject to further research.
- Compulsive sexual behaviour issues, including obsession with pornography, would come under the new definition of "hypersexual disorder". This would apply to people who repetitively engage in sexual “fantasies, urges and behavior”, and who repeatedly try and fail to control or significantly reduce the urges and behaviour.
So "pornography addiction" and "sex addiction" don't get definitions in their own right, but would be recognised as hypersexuality issues. One line from the proposed criteria for hypersexual disorder particularly leapt out at me:
"Repetitively engaging in these sexual fantasies, urges, and behavior in response to dysphoric mood states (e.g., anxiety, depression, boredom, irritability)."
Now all these proposals are still being fleshed out, and they'll be field tested for some time. Many experts have argued against inclusion of behavioural or "non-substance" addictions in the DSM on the basis that we will focus too much on the "addiction" and not the real, underlying problems.
Psychoanalyst Todd Essig is bang on the nail:
Making bad choices, developing destructive habits, and attempting solutions to problems in living that then become serious problems themselves will all become less important as the locus of responsibility shifts from the person doing something to the something being done.
To my mind, addiction therapy is a two-pronged approach:
- Help the person to directly address the behaviour; learn to develop an observing self that can notice and manage the specific trigger scenarios.
- Explore and address any underlying issues or trauma.
The balance and combination of both approaches is what makes good therapy. So the proposed new definition and criteria looks useful, even if "hypersexual disorder" might seem a somewhat misleading title at first. While I still have reservations about "addictions" in the DSM, I'm pretty optimistic about the inclusion of compulsive porn behaviour in this way.
You can read (and comment on) the proposed "hypersexual disorder" DSM-5 revision. Todd Essig's excellent article about "internet addiction" is here in full.
Porn Game Over is Jason's self-help plan for quitting the habit. Click here for a fresh approach to internet pornography addiction...
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6 comments
Hello, The FACT that a
Hello,
The FACT that a prestigious leading academic institution in the US in the field of psychology, psychiatry & psychotherapy CANNOT a text book definition of what we call porn addiction. Is extremely telling !! this shows how difficult & highly complex & diverse the problem of our relationship to porn is. If porn was not so complex we would have certainly had a clearer understanding of the nature of this difficulty.
Here is my own attempt at a definition of what I term porn dependency:-
PORN DEPENDENCY: A pattern of compulsive behavior driven by the irrational urge to view & use explicit sexual images frequently, with the potential towards to transferring of our normal dependency needs to porn itself.
Porn dependency also involves the repression or denial of feelings which the individual may not be able to face or deal with. Using porn has the potential to split the psyche into a divided self (i.e. the repressed self & the un-repressed self) this is characterized by a numbing effect or symptoms of disassociation.
To put it yet another way,
To put it yet another way, Porn is NOT a mental illness, nor in my opinion is porn an addiction in the medical sense of addiction (different in nature from alcohol or drug addictions). So I don't believe trying to treat someone with a so called porn addiction from a medical point of view is going to be helpful. Therefore the diagnosis of the problem or nature of the problem begins to appear far more important, because until the diagnosis is accurate how are you going to treat this condition, let alone know if there is a way to heal or cure the problem.
In my considered opinion with porn its the other way around, i.e. its the act of viewing & use of the porn that then has a negative impacts on the persons psyche & life. This in turn can takes its toll & have a bad effect on that persons mental emotional well being. In this sense YES! porn is a scourge of our times. But I don't believe having a porn dependency is a medical condition & thus it shouldn't be treated as such. Porn dependency needs skilled help from counselors or psychotherapists because its a condition or problem associated with mental healthy & well being not one that can be treated with drugs or addiction programs.
It must be good that the
It must be good that the experts are agreeing on the true basis of porn addiction. Depression, stress or other problems in life. So why then call it HYPERSEXUAL disorder? The problem is that it sounds like rabid addiction to sex or playing with yourself. If people are uncomfortable with facing the problem and getting help now, whats it going to be like when they have to face up to being "hypersexual"?
Hi DuncanS, YES! I have to
Hi DuncanS,
YES! I have to strongly agree calling something "Hyper-sexual or hyper-sexuality disorder" definitely doesn't help, in my view its just yet another rather abstract & academic intellectual label by the so called psychological experts. Once again this label is just as unhelpful as the term porn addiction. I personally don't believe in something called porn addiction even though this website is called quit-porn-addiction. Even Jason would agree with me to some degree. Porn is problematic because of the effects or impact it has on those people that view & consume it. The problem is NOT the porn itself but our relationship too porn, i.e. what drives us to use it in the first place.
Using porn is a pay off, but the price a person pays is not at all obvious to start with but only becomes clearer as time goes by. We risk trading "real love" to viewing at the act of copulation (un-touchable simulated love making), we risk trading real intimacy i.e. our intimacy needs with the illusion of intimacy (you cannot have intimacy with a porn picture), we risk trading our real feelings of heart felt love with a closed heart. Thus using porn is a bit like making a pact with the devil, we give up so much for such self deception for such little fake short lived pleasures but we pay a big price in many other ways.
I think, if the person is
I think, if the person is still hanged on what name his issue has, he is not ready to work on it yet.
When and if the person doesn't care if its called addiction or hupersexuality, or anything else, he is ready to work on it.
I'm not comparing this problem with illness, but just to make a point: when your sick, you don't care what your disease is called, you just want to get better.And again porn dependency is not a mental illness and shouldn't be seen like one. I think its all about choices. If you keep making bad choices everybody, of course its going to have bad affects in your life and well being, doesn't matter what they are. If you watch too much tv, you gonna have the same results, if you don't study for school you going to start feeling bad about yourself, if you never take your dog out for a walk, its gonna come a point that you will feel guilty. And so on and so on. That's my opinion.
And the more time we spend on finding a name for it, the less time we spend on finding a way to fix it.
Given some of the ridiculous
Given some of the ridiculous things that they chose in the DSM-IV, I'm not surprised the psychiatric community are having a trouble getting a grip on this. I have seen several psychiatrists over the years and only 1 - count 'em, 1 - had a clue that medication is only part of the battle regarding improving behaviour. I wish the DSM was in the hands of psychologists.
In my experience, I know pornography mucked up my brain chemistry, I felt a shift happen. I have at some points considered it an addiction (it was beyond the scope of what someone with any self respect should be participating in for a couple of years and I am still in a risky zone for sure). I more often considered it a compulsion. I would not go looking for it very often if it wasn't around, but if I was bored and I could fire up the internet, I would watch for hours. If I felt powerless or angry, I'd log on, too. Strangely enough, it rarely was because I was horny. That's hard to digest - I hardly ever looked at porn because I was horny. Unbelievable. I think the last time I looked at porn because I was curious or excited in a sexual way might have been as a teenager. Dear god what a waste of years of my life.
I can't see "hypersexual disorder' catching on as a label. Whatever they do, I hope they come up with something helpful, though. I'm still in the risky zone, but I don't want to feel the horror and anguish I felt ever again, ever, and if the DSM-V can come up with a framework to help mental health professionals help people, fantastic. I spent four years with a therapist and two of them were spent mostly on pornography, and he didn't have a clue how to help me. I felt angry at him for a long time because he was too nice about it (a stern lecture works with me sometimes), but in the end he and I were unfortunately both kind of clueless what to do.
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